Physician Reviewer - J29, Inc

General Description: J29, Inc. has been supporting commercial, State, and Federal health and human service programs since company inception in 2017. Our team of 260 employees focuses on providing claim, policy, and clinical analysis on the end-to-end of medical cases, claims, disputes, appeals, and audits. Our team is experienced in program, payment, provider, and patient integrity as we continue to support advanced programs of policy, clinical requirements, and compliance measures at the commercial, State, and Federal levels. 

J29 was founded to be an employee-centric company that prioritizes the well-being and value of its employees. Our mission is to empower our employees to do great things for the benefit of those that needs us most. The J29 mission supports not only our health and human service programs, but also the philanthropy efforts of our team. We are proud to continue our support to non-profit groups with critical missions as J29 continues to grow 

J29 is seeking a dedicated and knowledgeable Physician Reviewer to join our team. As a Physician Reviewer, you will play a crucial role in ensuring the accuracy and quality of medical information within the healthcare industry. Your responsibilities will include conducting thorough reviews of medical documents for accuracy and completeness, evaluating the relevance and reliability of medical information, and providing detailed feedback and recommendations to medical practitioners. You will also collaborate with healthcare teams to ensure compliance with industry standards and maintain up-to-date knowledge of medical advancements and regulations.  

Key Responsibilities: 

 - Reviewing and analyzing medical documents, reports, and records for accuracy and completeness. 

 - Evaluating the compliance of medical activities with regulatory standards. 

 - Providing expert opinions and recommendations on medical issues. 

 - Collaborating with healthcare teams to ensure compliance with industry standards. 

 - Maintaining up-to-date knowledge of medical advancements and regulations.  

Requirements and Skills: 

 - Medical degree in good standing (Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), Doctor of Dental Surgery (D.D.S.), Doctor of Medical Dentistry (D.M.D.), Doctor of Podiatric Medicine (D.P.M.), Doctor of Optometry (O.D.), or Doctor of Chiropractic (D.C.)) and relevant professional certifications.  

- Board certification by the American Board of Medical Specialists or American Dental Association. 

- Degree from an accredited university and licensed to practice in a state in the United States of America, D.C., Puerto Rico, Guam, and/or the Virgin Islands. 

- Possesses malpractice insurance coverage that includes liability for content of medical and dental review determinations and consultation services, as well as general liability insurance 

- Attention to detail and strong analytical skills.  

- Excellent communication and interpersonal skills.  

- Up-to-date knowledge of medical regulations and industry trends. 

 - Ability to work independently and collaborate with multidisciplinary teams.  

Joining J29 as a Physician Reviewer offers a challenging yet rewarding career path in the healthcare sector. By contributing to maintaining high standards of medical information, you will play a vital role in ensuring the well-being of patients and the success of our consulting services.  
 

J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class.  J29, Inc. is a proud Veteran friendly employer. 

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